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Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions.

Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K - Korean J Radiol (2015)

Bottom Line: Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine.However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts.In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. ; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan.

ABSTRACT
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

No MeSH data available.


Related in: MedlinePlus

Hemorrhagic hyperdense fluid in stomach in 65-year-old deceased woman with liver cirrhosis and esophagogastric varices (case 10).CT scan obtained 13 hours and 33 minutes after death shows content with two different densities in gastric lumen. Higher density material in gastric lumen (arrows) is clumped, covers lower density material, and is suspected to be caused by rupture of esophagogastric varices. This was proven on subsequent autopsy. CT = computed tomography
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Figure 8: Hemorrhagic hyperdense fluid in stomach in 65-year-old deceased woman with liver cirrhosis and esophagogastric varices (case 10).CT scan obtained 13 hours and 33 minutes after death shows content with two different densities in gastric lumen. Higher density material in gastric lumen (arrows) is clumped, covers lower density material, and is suspected to be caused by rupture of esophagogastric varices. This was proven on subsequent autopsy. CT = computed tomography

Mentions: In case 10, the patient had a history of liver cirrhosis, which was detected on postmortem CT, as were esophagogastric varices. On postmortem CT, the gastric contents showed two different densities. We suspected that the higher density material resulted from a rupture of the esophagogastric varices (Fig. 8), which was confirmed on the subsequent autopsy. The two differing densities within the gastric lumen on postmortem CT were identified as hemorrhage and food on autopsy. This case suggests that higher density material in the gastric lumen clumps and covers less dense material, and that the existence of liver cirrhosis and esophageal varices may be a cause of intragastric hematoma. The medical history before death can suggest the source of mixed density fluid identified on postmortem CT.


Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions.

Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K - Korean J Radiol (2015)

Hemorrhagic hyperdense fluid in stomach in 65-year-old deceased woman with liver cirrhosis and esophagogastric varices (case 10).CT scan obtained 13 hours and 33 minutes after death shows content with two different densities in gastric lumen. Higher density material in gastric lumen (arrows) is clumped, covers lower density material, and is suspected to be caused by rupture of esophagogastric varices. This was proven on subsequent autopsy. CT = computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499544&req=5

Figure 8: Hemorrhagic hyperdense fluid in stomach in 65-year-old deceased woman with liver cirrhosis and esophagogastric varices (case 10).CT scan obtained 13 hours and 33 minutes after death shows content with two different densities in gastric lumen. Higher density material in gastric lumen (arrows) is clumped, covers lower density material, and is suspected to be caused by rupture of esophagogastric varices. This was proven on subsequent autopsy. CT = computed tomography
Mentions: In case 10, the patient had a history of liver cirrhosis, which was detected on postmortem CT, as were esophagogastric varices. On postmortem CT, the gastric contents showed two different densities. We suspected that the higher density material resulted from a rupture of the esophagogastric varices (Fig. 8), which was confirmed on the subsequent autopsy. The two differing densities within the gastric lumen on postmortem CT were identified as hemorrhage and food on autopsy. This case suggests that higher density material in the gastric lumen clumps and covers less dense material, and that the existence of liver cirrhosis and esophageal varices may be a cause of intragastric hematoma. The medical history before death can suggest the source of mixed density fluid identified on postmortem CT.

Bottom Line: Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine.However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts.In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. ; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan.

ABSTRACT
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

No MeSH data available.


Related in: MedlinePlus